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Early start of chemotherapy after resection of primary colon cancer with synchronous multiple liver metastases: a case report.

Yoshida Y, Hoshino S, Shiwaku H, Beppu R, Tanimura S, Tanaka S, Yamashita Y - Case Rep Oncol (2011)

Bottom Line: However, there is no evidence to indicate the required length of this delay interval.Here, we present a case in which combination chemotherapy with capecitabine and oxaliplatin (XELOX) was started within 1 week after a right hemicolectomy for synchronous multiple liver metastases.To our knowledge, this is the first report of the start of chemotherapy, involving treatments such as folinic acid, fluorouracil, and oxaliplatin (FOLFOX); folinic acid, fluorouracil, and irinotecan (FOLFIRI); and XELOX, within 1 week after a colorectal cancer operation with anastomosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.

ABSTRACT
The start of chemotherapy treatment usually requires a delay of about 4 weeks after surgical resection in patients with primary colorectal cancer and synchronous distant metastasis. However, there is no evidence to indicate the required length of this delay interval. In addition, there is a chance that a patient may die because postoperative chemotherapy was not started soon enough and a metastatic tumor was able to develop rapidly. Here, we present a case in which combination chemotherapy with capecitabine and oxaliplatin (XELOX) was started within 1 week after a right hemicolectomy for synchronous multiple liver metastases. To our knowledge, this is the first report of the start of chemotherapy, involving treatments such as folinic acid, fluorouracil, and oxaliplatin (FOLFOX); folinic acid, fluorouracil, and irinotecan (FOLFIRI); and XELOX, within 1 week after a colorectal cancer operation with anastomosis. The findings suggest possible changes in the start time of chemotherapy after surgery in the future.

No MeSH data available.


Related in: MedlinePlus

Resected colon specimen. The resected colon specimen revealed a tumor in the ascending colon. The oral side of the tumor was accompanied by significant edema.
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Figure 2: Resected colon specimen. The resected colon specimen revealed a tumor in the ascending colon. The oral side of the tumor was accompanied by significant edema.

Mentions: A 43-year-old man was referred to our hospital with upper abdominal pain and abdominal fullness. Colonoscopy revealed a nearly obstructing tumor in the ascending colon. Stenosis prevented the endoscope from passing through. The patient needed to be fasted because of the stenosis of the ascending colon. Abdominal CT revealed more than 20 hepatic metastases (fig. 1a). The patient underwent a right hemicolectomy (open surgery) with functional end-to-end anastomosis. The oral side of the tumor was accompanied by significant edema and expansion of the ileum (fig. 2). No drain was used, and the nasogastric tube was removed immediately after surgery. After surgery, the patient was allowed to drink water. On postoperative day 1, the patient was offered a meal. The postoperative recovery was uneventful. The patient strongly hoped for an early start of chemotherapy on postoperative day 5. Therefore, we started XELOX therapy on postoperative day 7 [oxaliplatin (130 mg/m2) on day 1 plus capecitabine (1,000 mg/m2) twice daily on days 1–14, every 3 weeks]. The patient was subsequently discharged in good condition on postoperative day 13. XELOX + bevacizumab [BV (7.5 mg/kg) and oxaliplatin (130 mg/m2) on day 1 plus capecitabine (1,000 mg/m2) twice daily on days 1–14, every 3 weeks] was administered on postoperative day 28. After 6 cycles of XELOX + BV, CT revealed a reduction in tumor size (fig. 1b). Laboratory studies revealed a serum carcinoembryonic antigen level of 1,499 ng/ml, which improved to 312 ng/ml after 6 cycles of chemotherapy. Observed adverse events that had previously appeared included only a peripheral neuropathy in the acute stage (Grade 1) and hand-foot syndrome (Grade 1). Hematological toxicity, surgical site infection, and incisional hernia were not noted.


Early start of chemotherapy after resection of primary colon cancer with synchronous multiple liver metastases: a case report.

Yoshida Y, Hoshino S, Shiwaku H, Beppu R, Tanimura S, Tanaka S, Yamashita Y - Case Rep Oncol (2011)

Resected colon specimen. The resected colon specimen revealed a tumor in the ascending colon. The oral side of the tumor was accompanied by significant edema.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3104872&req=5

Figure 2: Resected colon specimen. The resected colon specimen revealed a tumor in the ascending colon. The oral side of the tumor was accompanied by significant edema.
Mentions: A 43-year-old man was referred to our hospital with upper abdominal pain and abdominal fullness. Colonoscopy revealed a nearly obstructing tumor in the ascending colon. Stenosis prevented the endoscope from passing through. The patient needed to be fasted because of the stenosis of the ascending colon. Abdominal CT revealed more than 20 hepatic metastases (fig. 1a). The patient underwent a right hemicolectomy (open surgery) with functional end-to-end anastomosis. The oral side of the tumor was accompanied by significant edema and expansion of the ileum (fig. 2). No drain was used, and the nasogastric tube was removed immediately after surgery. After surgery, the patient was allowed to drink water. On postoperative day 1, the patient was offered a meal. The postoperative recovery was uneventful. The patient strongly hoped for an early start of chemotherapy on postoperative day 5. Therefore, we started XELOX therapy on postoperative day 7 [oxaliplatin (130 mg/m2) on day 1 plus capecitabine (1,000 mg/m2) twice daily on days 1–14, every 3 weeks]. The patient was subsequently discharged in good condition on postoperative day 13. XELOX + bevacizumab [BV (7.5 mg/kg) and oxaliplatin (130 mg/m2) on day 1 plus capecitabine (1,000 mg/m2) twice daily on days 1–14, every 3 weeks] was administered on postoperative day 28. After 6 cycles of XELOX + BV, CT revealed a reduction in tumor size (fig. 1b). Laboratory studies revealed a serum carcinoembryonic antigen level of 1,499 ng/ml, which improved to 312 ng/ml after 6 cycles of chemotherapy. Observed adverse events that had previously appeared included only a peripheral neuropathy in the acute stage (Grade 1) and hand-foot syndrome (Grade 1). Hematological toxicity, surgical site infection, and incisional hernia were not noted.

Bottom Line: However, there is no evidence to indicate the required length of this delay interval.Here, we present a case in which combination chemotherapy with capecitabine and oxaliplatin (XELOX) was started within 1 week after a right hemicolectomy for synchronous multiple liver metastases.To our knowledge, this is the first report of the start of chemotherapy, involving treatments such as folinic acid, fluorouracil, and oxaliplatin (FOLFOX); folinic acid, fluorouracil, and irinotecan (FOLFIRI); and XELOX, within 1 week after a colorectal cancer operation with anastomosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.

ABSTRACT
The start of chemotherapy treatment usually requires a delay of about 4 weeks after surgical resection in patients with primary colorectal cancer and synchronous distant metastasis. However, there is no evidence to indicate the required length of this delay interval. In addition, there is a chance that a patient may die because postoperative chemotherapy was not started soon enough and a metastatic tumor was able to develop rapidly. Here, we present a case in which combination chemotherapy with capecitabine and oxaliplatin (XELOX) was started within 1 week after a right hemicolectomy for synchronous multiple liver metastases. To our knowledge, this is the first report of the start of chemotherapy, involving treatments such as folinic acid, fluorouracil, and oxaliplatin (FOLFOX); folinic acid, fluorouracil, and irinotecan (FOLFIRI); and XELOX, within 1 week after a colorectal cancer operation with anastomosis. The findings suggest possible changes in the start time of chemotherapy after surgery in the future.

No MeSH data available.


Related in: MedlinePlus